What Does Pelvic Congestion Syndrome Mean?

Pelvic congestion syndrome is a common cause of ongoing pelvic pain in women. It occurs when pelvic veins associated with the uterus or ovaries become enlarged, swollen or dilated. This pain is unrelated to menstruation. Doctors believe it can be the source of pain in up to 30 percent of women who have chronic pelvic pain.

The condition, also called pelvic venous insufficiency, is rare in women who have never experienced pregnancy. However, women with polycystic ovaries, hormonal dysfunction, or varicose veins on their vulva may be more at risk. If you have pain that persists for more than six months and isn't associated with pregnancy or menstruation, you may have this condition. Approximately one-third of all women will suffer from pelvic congestion syndrome symptoms at some point in their lives. It is most common in women ages 20 to 45 with more than one child.

What are the Symptoms?

The pelvic pain associated with PCS usually involves faulty veins in the pelvis and ovaries. These veins widen and can become twisted and overfilled with blood. Blood pools in your pelvis, causing discomfort. Approximately 40% of gynecological visits involve chronic pelvic pain, with three-quarters of these involving Pelvic Congestion Syndrome.

In addition to a dull ache or dragging pain in the pelvis or lower back, women may experience other Pelvic Congestion Syndrome symptoms. These can include:

• Dysmenorrhea (painful menstruation).
• Abnormal bleeding during menstruation
• Varicose veins around the vulva, buttocks, and legs
• Abnormal vaginal discharge
• Swelling of the vagina or vulva
• Tenderness of the abdomen
• Increased urination
• Pain during urination
• Hip pain
• Irritable bowel syndrome
• Stress incontinence
• Deep discomfort during or after sexual intercourse

What Causes Pelvic Congestion Syndrome (PCS)?

The cause of pelvic congestion syndrome is unclear. However, anatomical or hormonal abnormalities or dysfunction may contribute to chronic pelvic pain. Hormonal changes and weight gain combined with anatomical changes in the pelvis during pregnancy can increase pressure within the ovarian veins. Pelvic veins may weaken and dilate. Estrogen can also weaken pelvic vein walls, making women more susceptible to PCS.

In normal vein function, blood flows from the pelvis toward the heart in the ovarian veins, with valves preventing backward blood flow. Valves don't close properly when ovarian veins dilate, resulting in reflux. This backward blood flow causes the pooling of blood, leading to pelvic varicose veins and chronic pelvic pain complaints.

Diagnosing Pelvic Congestion Syndrome

Although PCS does not have a cure, getting an early diagnosis and treatment can help patients cope with the symptoms and improve their quality of life. Pelvic congestion syndrome is frequently confused with premenstrual difficulties, ovarian cysts, uterine fibroids, or other gynecological issues. Because of these confusing symptoms, work with a vascular surgeon, your primary care provider and a gynecologist to determine if you have any underlying causes.

Getting pelvic congestion syndrome diagnosed properly involves a physical examination, a thorough medical history and imaging studies to confirm the syndrome's presence and rule out other possible causes of chronic pelvic pain.

Symptom Evaluation and Medical History

Discussing your lower abdominal pain symptoms and your medical history with a vascular specialist is the first step. Your provider will assess your pelvis to seek signs of various signs, swelling and pelvic venous insufficiency. You can expect palpation to detect tenderness, swelling or abnormalities that may indicate pelvic congestion syndrome (PCS).

Imaging Techniques

Imaging is essential to diagnose pelvic congestion syndrome. Various techniques are used, including pelvic ultrasound, pelvic venography, magnetic resonance imaging (MRI), computed tomography (CT) scan, and IVUS, a specialized ultrasound technique to visualize the interior of blood vessels. Ultrasound uses sound waves to visualize pelvic organs and veins. Pelvic venography involves injecting a contrast dye and using X-rays to see pelvic veins.

Through careful evaluation of clinical symptoms and diagnostic information, your doctor can make an accurate diagnosis and develop an effective treatment plan to relieve symptoms and chronic pain.

Treatment of Pelvic Congestion Syndrome

Unfortunately, there is no way to prevent pelvic congestion syndrome, nor is there a definite cure for the condition. Treatment of pelvic congestion system is usually aimed at reducing and alleviating symptoms. Initial treatment often involves conservative self-care measures. Wearing compression garments like pantyhose or shorts can help improve blood flow in the pelvis and relieve symptoms and swelling.

Ibuprofen or naproxen can help reduce inflammation and alleviate pelvic pain and painful menstrual cycles. Estrogen levels can influence the development and severity of pelvic congestion syndrome. Hormone agonists and other hormonal treatments, such as birth control pills and hormone replacement therapy, may be used according to a patient's specific needs.

Currently, the most successful treatment is a minimally invasive surgical procedure called pelvic embolization. Pelvic or ovarian vein embolization blocks off specific varicose veins in the pelvis and lower extremities, believed to be the source of pain.

Discuss Your Pelvic Congestion Syndrome Symptoms With VIVAA

If you experience chronic pelvic pain or other symptoms of PCS, consult with a board-certified vein specialist at VIVAA to explore your diagnostic and treatment options. Our Seattle-area medical spa and primary care practice specializes in vein treatments. Contact our practice today by calling 425-250-9999 or completing our schedule a consultation form.